Safety and efficacy of carbon nanoparticles in operation for papillary thyroid carcinoma

doi:10.16139/j.1007-9610.2018.01.011

Abstract

Abstract: Objective To evaluate the safety and clinical efficacy of carbon nanoparticles (CN) as a tracer in surgical operation for papillary thyroid carcinoma patients with a history of thyroid resection. Methods A retrospective analysis was performed using the clinical data of 53 cases with thyroid papillary carcinoma who had a history of thyroid resection receiving total thyroidectomy combined with lymph node dissection. Twenty-seven cases had CN intra-operative treatment as CN group and 26 cases as control group without CN. Results The lymph node dissection was much more in CN group than in control group (P<0.01). However, there was no difference in the dissection of metastatic lymph node (P=0.077). A total of 176(73.33%) were stained black in 240 dissected lymph nodes of CN group, among which 42(23.86%) lymph nodes were metastatic. Pathologic examination revealed that there were parathyroid in resection specimens from 3 cases in CN group compared with 9 cases in control group (P=0.041). Three cases with hypocalcemia was found in CN group and 10 cases in control group on the postoperative day(P=0.021). However, postoperative hoarseness had no statistical difference between CN group and control group (P=0.280). Conclusions Using CN during the operation of papillary thyroid carcinoma would be beneficial to the patients with history of thyroid resection reducing parathyroid injury and keeping serum calcium and phosphorus stable.

Key words: Papillary thyroid carcinoma, Reoperation, Carbon nanoparticles, Complications

CLC Number:

R736.1

FENG Haoran, KUANG Jie, CHENG Xi, JIN Zhijian, YANG Weiping, QIU Weihua, TAN Jian. Safety and efficacy of carbon nanoparticles in operation for papillary thyroid carcinoma[J]. Journal of Surgery Concepts & Practice, 2018, 23(01): 48-51.

References

[1] Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017[J]. CA Cancer J Clin,2017,67(1):7-30.
[2] Chen WQ, Zheng RS, Peter D, et al.Cancer Statistics in China, 2015[J]. CA Cancer J Clin,2016,66:115-132.
[3] Yang F, Jin C, Yang D, et al.Magnetic functionalised carbon nanotubes as drug vehicles for cancer lymph node metastasis treatment[J]. Eur J Cancer,2011,47(12):1873-1882.
[4] Yu W, Cao X, Xu G, et al.Potential role for carbon nanoparticles to guide central neck dissection in patients with papillary thyroid cancer[J]. Surgery,2016,160(3):755-761.
[5] Mazzaferri EL, Massoll N.Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin[J]. Endocr Relat Cancer,2002,9(4):227-247.
[6] Simon D, Goretzki PE, Witte J, et al.Incidence of regional recurrence guiding radicality in differentiated thyroid carcinoma[J]. World J Surg,1996,20(7):860-866.
[7] Conzo G, Avenia N, Bellastella G, et al.The role of surgery in the current management of differentiated thyroid cancer[J]. Endocrine,2014,47(2):380-388.
[8] Hay ID, Thompson GB, Grant CS, et al.Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trend in initial therapy and long-term outcome in 2444 consecutively treated patients[J]. World J Med,2002,26(8):879-885.
[9] Mazzaferri EL, Jhiang SM.Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer[J]. Am J Med,1994,97(5):418-428.
[10] Dionigi G, Bacuzzi A, Bertocchi V, et al.Prospectives and surgical usefulness of perioperative parathyroid hormone assay in thyroid surgery[J]. Expert Rev Med Devices,2008,5(6):699-704.
[11] Lim DJ, Baek KH, Lee YS, et al.Clinical, histopatholo-gical, and molecular characteristics of papillary thyroid microcarcinoma[J]. Thyroid,2007,17(9):883-888.
[12] Han N, Bumpous JM, Goldstein RE, et al.Intra-operative parathyroid identification using methylene blue in parathyroidsurgery[J]. Am Surg,2007,73(8):820-823.
[13] Hao RT, Chen J, Zhao LH, et al.Sentinel lymph node biopsy using carbon nanoparticles for Chinese patients with papillary thyroid microcarcinoma[J]. Eur J Surg Oncol,2012,38(8):718-724.
[14] Catarci M, Guadagni S, Zaraca F, et al.Prospective randomized evaluation of preoperative endoscopic vital staining using CH-40 for lymph node dissection in gastric cancer[J]. Ann Surg Oncol,1998,5(7):580-584.
[15] Vasala A, Nair HG, Rao ST, et al.Impact of methylene blue staining in the retrieval of lymph nodes in resected colorectal cancer specimens[J]. Indian J Pathol Microbiol,2016,59(4):504-506.
[16] Li Y, Jian WH, Guo ZM, et al.A meta-analysis of carbon nanoparticles for identifying lymph nodes and protecting parathyroid glands during surger[J]. Otolaryngol Head Neck Surg,2015,152(6):1007-1016.
[17] Bruno R, Giannasio P, Chiarella R, et al.Identification of a neck lump as a lymph node metastasis from an occult contralateral papillary microcarcinoma of the thyroid: key role of thyroglobulin assay in the fine-needle aspirate[J]. Thyroid,2009,19(5):531-533.